Candidates Diverge On Health Care Remedies

May 02, 1994|by ANN WLAZELEK, The Morning Call

Santorum and Watkins would require individuals to buy health insurance rather than forcing employers to pay for employee benefits. Both oppose abortion services and support limits on malpractice awards. Santorum says non-economic damages should not exceed $250,000, adjusted annually for inflation, and lawyers' contingency fees should be capped at 25 percent.

The Republicans are split, however, on the issues of raising "sin" taxes to pay for expanded coverage and on allowing a national board to set spending limits.

Watkins would allow a tax increase on cigarettes, alcohol and firearms; Santorum would not. Also, Watkins supports a national cap on spending, provided it doesn't force rationing. Santorum says no to board-set limits.

Santorum introduced the idea of a medical savings account, called Medisave, which has become part of the Gramm bill. Under it, workers would buy major medical insurance and could make tax-free contributions to a Medisave account, from which they would pay for preventive services.

Watkins said he believes the country can save as much as $76 billion by eliminating duplication of services and government bureaucracy. He also would require individuals to pay part of their health care bills.

In the state governor's race, the Republicans oppose mandates on employers providing health insurance, including abortions in basic benefits packages and setting national spending limits.

Ridge supports open enrollment rather than government mandates to provide health insurance. "If there a slight increase in premiums, it's better than turning the system over to the government," he said. "You don't turn anything over to the government if you need it done cheaper."

He supports an increase in taxes on cigarettes, alcohol and firearms, and caps on punitive damages to help pay for benefits for the uninsured.

Preate agrees to sin taxes and limiting consumers' rights to sue, too. In addition to the medical savings accounts, Preate favors copays, portability of insurance from job to job and insurance reform to prevent the disqualification of someone already sick or injured.

Katz wants to preserve individuals' rights to choose doctors and health care plans without rationing, price controls, or limits on consumers' rights to sue for injury. He opposes tax increases, even sin taxes, to pay for that reform.

Under his "Equicare" proposal, people who now have employer-paid health coverage would have 90 percent of those dollars turned over to them as tax-free accounts, from which they would be required to buy health insurance.

For example, a typical Pennsylvania family with two wage earners has $5,200 a year spent on them for health insurance by their employers. Equicare would provide about $4,700 in tax-free health coverage. If the couple purchased health insurance for $4,200, they would have $500 remaining as a "medical IRA" for out-of-pocket expenses.

Businesses would put the remaining 10 percent into a pool with government funds to cover the uninsured.

Perry, an orthopedic surgeon, said he opposes government mandates and believes free market competition will bring insurance prices down, making it affordable for more people.

"The reason health care costs are high is because of government-induced distortions of the marketplace," he said. "Forty percent of today's costs are directly from the government."

Perry would give each taxpayer a tax credit based on a health insurance deductible over $1,000, then put the tax savings in tax-free accounts for out-of-pocket medical expenses.

Fisher supports increased competition among doctors and hospitals, insurance pools for small businesses and malpractice reform. He's against raising sin taxes, but for limiting consumers' rights to sue for injuries.

There was no consensus among the responding Democratic candidates for governor on any of the questions asked. All but Valenti said they support universal coverage, and a majority favored increasing sin taxes. Also, all but Valenti opposed limiting consumers' rights to sue for malpractice.

Singel, Evans, Knoll and Yeakel said they support the Clinton/Casey approach to reform, yet have differing views about forcing employers to provide benefits and the amount employees should pay.

Evans would not require employers to provide health benefits to workers, while Singel, Knoll and Yeakel would.

Singel and Knoll agree that 20 percent is a fair amount that employees should have to pay toward their premium. The other Democratic candidates said they didn't know or wouldn't answer.

On abortion, Singel, Evans and Yeakel said a basic benefits package should cover the service; Knoll and Valenti said it should not.

Singel, Knoll and Yeakel said it's OK to increase tax on cigarettes, alcohol and firearms, although Yeakel said it should be done on the federal level.